Objective: To demonstrate the correlation of optic nerve sheath diameter (ONSD) on initial computed tomography (CT) with outcome and radiological classification systems in pediatric intensive care unit (PICU) patients with head trauma.
Methods: Patients who were admitted to the PICU due to head trauma between June 2018-December 2022 were retrospectively analyzed. Both side ONSD and eye transverse diameters (ETD) were measured from head CTs at admission. CT findings were scored according to the Marshall and Rotterdam classifications of traumatic brain injury (TBI). Traumatic injury mechanisms, Glasgow coma scores, and outcomes were recorded from the hospital database.
Results: Mean ONSD differed significantly with age (p<0.001) and poor outcome (p=0.005). ONSD was also significantly higher in 0-2 and >10-year-old groups with severe TBI according to Rotterdam classification. The mean ONSD/ETD ratio was also significantly correlated with age, outcome, and Rotterdam classifications (p<0.001, r2=0.583; p=0.031, r2=0.207; p=0.008, r2=252, respectively.).
Conclusion: ONSD and ONSD/ETD ratio are feasible measurements that clearly correlate with prognosis and severe TBI in pediatric patients.